| Organization Name: | JAMES AVERSA OD PA |
| NPI Number: | 1346411006 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES JOHN AVERSA (OPTOMETRIST) |
| Mailing Address: | 227 1/2 Blvd. Hasbrouck Heights |
| State: | NJ US |
| Postal Code: | 076041901 |
| Phone Number: | 2012881109 |
| Fax Number: | 2012881589 |
| NPI Enumeration Date: | 03/20/2008 |
| NPI Last Update Date: | 03/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 27TO00028300 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |